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The ranking of therapies is based on their pathway-targeting effectiveness within the DM2-AD comorbidity network, and while metformin demonstrates the highest engagement with key neuroprotective mechanisms, and semaglutide among the least, this does not imply complete inefficacy of lower-ranked therapies

Injectable B12 may deliver better results because: Direct bloodstream access bypasses digestive absorption barriers Higher bioavailability allows for less frequent dosing Consistent therapeutic levels maintain steady benefits [6] Disclaimer: The FDA does not approve compounded medications for safety, quality, or manufacturing

ACS Cent Sci 6(1):4153

No.S1420087 CAS

FDA issued a Complete Response Letter to Helsinn Therapeutics in 2017 that was never resubmitted (verified 2026-05-19)

This said, stimulants may still be a reasonable first therapeutic choice for previously untreated children with ASD and uncomplicated ADHD